Provider Demographics
NPI:1760128169
Name:MINNESOTA CHIROHEALTH OF WEST END LLC
Entity Type:Organization
Organization Name:MINNESOTA CHIROHEALTH OF WEST END LLC
Other - Org Name:WEST END CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-500-8477
Mailing Address - Street 1:1660 HIGHWAY 100 S STE 146B
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1529
Mailing Address - Country:US
Mailing Address - Phone:952-500-8477
Mailing Address - Fax:952-500-9522
Practice Address - Street 1:1660 HIGHWAY 100 S STE 146B
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1529
Practice Address - Country:US
Practice Address - Phone:952-500-8477
Practice Address - Fax:952-500-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty